Cauterization of cervical erosion: basic methods

As a radical method of treating pathological changes in the mucous membrane, cauterization of cervical erosion is performed, during which the destruction of affected tissues occurs with their necrosis, rejection and subsequent regeneration of healthy cells of the mucous epithelium at the affected site.

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Indications and preparation for cauterization of cervical erosion

Indications for cauterization of cervical erosion are diagnosed ectopia, leukoplakia or erythroplakia of the cervical mucosa (with or without discharge). No special preparation is usually carried out. However, if pathogenic bacterial, viral or fungal microflora is detected in the vagina, the doctor prescribes drugs to treat the corresponding infectious disease. Cauterization of erosion is the most appropriate method - it is performed upon achieving a positive result of antibacterial, antiviral or antifungal therapy.

According to the recommendations of specialists, this procedure is performed during the first phase of the patient’s menstrual cycle – on the 7th-9th day, which ensures faster healing and restoration of the mucous membrane and reduces the risk of developing cervical endometriosis.

The necessary tests before cauterization of cervical erosion include a smear of vaginal microflora and its PCR analysis for STDs (sexually transmitted diseases); a complete blood count; a blood test for RV, HIV and hepatitis; a biopsy and histological examination of the tissue at the site of the erosion.

Methods of cauterization of cervical erosion

In clinical gynecology today the following methods of cauterization of cervical erosion are used:

• electric current (diathermocoagulation);
• nitrogen or, as it is often called, cryodestruction, freezing - the destruction of pathologically altered tissues by exposure to extremely low temperatures;
• laser (laser vaporization);
• radio waves (radio wave coagulation);
• argon (argon plasma ablation method);
• ultrasound;
• medicinal or chemical cauterization.

The most traumatic method is recognized by doctors themselves as diathermocoagulation: this is, in fact, a local contact thermal burn of the mucous membrane of the cervix with all the ensuing consequences. Moreover, the action of high-frequency current also leads to spasms of the uterine muscles, and, in addition, in half of the cases, erosion can occur again.

Cryodestruction and laser vaporization methods are effective for small and shallow erosions. Freezing is performed with liquid nitrogen (its temperature is about -196°C), the procedure is practically painless and does not leave keloid scars. Laser vaporization is also effective, painless and bloodless, in which the erosion simply evaporates under the action of a precisely directed laser beam. The site of mucosal necrosis is covered with a coagulation film, ensuring the absence of bleeding and associated infection. The wound at the site of the erosion quickly heals with healthy tissue - without a single scar.

For radio wave coagulation, a modern low-frequency electrosurgical device for cauterization of cervical erosion Surgitron is used. This method is minimally invasive, since the effect of electric current converted into radio waves occurs in a contactless manner. Due to the absence of complications, in particular, the formation of scars that reduce the elasticity of the cervical walls, most gynecologists consider cauterization with Surgitron to be a priority method of treating nulliparous women.

During radio wave treatment, cauterization is also performed with Fotek - a cavitation ultrasonic surgical device of various modifications (most often this is the Fotek E80M device).

If they resort to argon plasma cauterization (Argon Plasma Coagulation), then the procedure for removing pathological erosion tissues is carried out using the electrosurgical device Fotek-140-04, equipped with a special block (EA142MV HF), or the plasma coagulator Argon Z. Argon ionized by high-frequency current through a special probe affects the eroded area with a clearly focused plasma beam, without contact with tissues.

Solkovagin cauterization is a method of contact chemical destruction. Solkovagin in the form of a solution is a mixture of concentrated acids - nitric, oxalic, acetic with zinc nitrate hexahydrate. Application of this agent (with a tampon) to the site of erosion leads to necrosis of epithelial cells - due to the immediate coagulation of their proteins. A scab forms at the site of cauterization, under which a layer of new epithelium is formed over time.

To monitor the tissue regeneration process, gynecological examinations are prescribed - 10 days after the procedure, then another two weeks later and 38-40 days after cauterization. The use of this drug causes burning and itching.

How long does it take to recover from cauterization of cervical erosion depends on the method used and the size of the affected area. On average, after cauterization with electricity, the mucous membrane regenerates in a couple of months, but it can take longer to heal; after cryodestruction, laser cauterization or radio wave treatment - in about a month and a half. But the duration of the regeneration process can increase: individual characteristics of the patient's body, the state of their immunity, the presence of infections, etc. can have an effect.

Cauterization of cervical erosion at home

Some doctors - for minor pathologies - recommend cauterizing cervical erosion at home with the antibacterial drug Polikrezulen (Vagotyl), which acts not only as a powerful bacteriostatic, but also, due to its formaldehyde content, produces a local cauterizing effect, coagulating the protein of eroded tissues.

The method of using this solution consists of applying a soaked tampon to the vaginal erosion area for 1-3 minutes, while the excess solution must be soaked with a dry sterile tampon. The number of procedures during the week is two or three (as the doctor says).

After a week, the dead tissue will begin to separate (discharge as with conventional chemical cauterization), leaving no scar. Since Polikrezulen is an antiseptic, the regeneration of epithelial cells that have undergone necrosis occurs fairly quickly and without inflammation. However, it is necessary to observe the same restrictions that any cauterization of cervical erosion implies.

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Consequences after cauterization of cervical erosion

The most common short-term effects are pain, swelling of the vulva and discharge.

Localized in the lower abdomen, severe pain after cauterization of cervical erosion especially often accompanies the diathermocoagulation procedure. Considering the dual innervation of the cervix and vagina, the occurrence of pain of varying intensity should not worry patients: these pains quickly pass.

The natural process of rejection of destroyed tissues also explains the discharge after cauterization of cervical erosion. Minor vaginal discharge - liquid consistency with an admixture of mucus will continue for up to 10 days after the procedure. There may also be bloody discharge, since when the mucous membrane is damaged for therapeutic purposes, a wound surface appears on it in any case and an exudate is formed, cleansing it of dead cells.

But significant bleeding, especially characteristic again for diathermocoagulation, indicates damage to one or more blood vessels of the cervix. In such situations, Tranexam (other trade names - Trenaxa, Tranestat) is prescribed - a hemostatic hemostatic drug (tablets of 250 mg): one tablet up to 4 times a day.

Gynecologists do not exclude such a complication of any of the methods of destruction used as a violation of the menstrual cycle or a delay.

When the discharge becomes yellowish or greenish-yellow, is accompanied by a putrid odor, and if the general temperature rises even slightly, then all this indicates the development of inflammatory processes.

Most often, inflammation occurs due to the presence or addition of urogenital infections. It is necessary to seek medical help without delay.

Doctors also warn about possible long-term negative consequences of cauterization of cervical erosion by diathermocoagulation associated with the formation of scars at the site of the detached scab. This is a narrowing (stenosis) of the cervical canal, accumulation of bloody exudate in it, dilation of the blood vessels of the cervix or the appearance of bleeding foci on its walls (endometriosis). This is fraught with anomalies during childbirth, premature birth, termination of pregnancy and even problems with the very possibility of becoming pregnant. Therefore, this method is not used in the treatment of cervical erosion in nulliparous patients.

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Recommendations after cauterization of cervical erosion

General recommendations after cauterization of cervical erosion include:

• abstinence from sexual contact (at least for a month);
• a ban on physical activity for 1-1.5 months, including dancing and any active sports;
• Contraindication for swimming in any body of water, including taking baths (only non-hot showers).

What else should not be done after cauterization of cervical erosion? You cannot use vaginal tampons: you should use only sanitary pads.

As an anti-inflammatory and antiviral agent (against genital herpes, cytomegalovirus and HPV), doctors recommend the local remedy Epigen spray, which also relieves itching and promotes mucosal regeneration.

If the patient is diagnosed with bacterial vaginosis, chlamydia or mycoplasmosis, antibiotics will be required. These are vaginal granules Polygynax (with polymyxin and neomycin sulfate). This drug is also prescribed for vaginal candidiasis, as it contains nystatin.

Also, when inflammation develops, Terzhinan is used - a combined antibacterial and antifungal agent in the form of vaginal tablets. Gynecologists may recommend them before diathermocoagulation (one tablet intravaginally before bedtime) - to reduce the risk of inflammation.